Neurasthenia in Norway 1880 - 1920

Editor's Comment: Neurasthenia was a neurological condition typified by unrefreshing sleep, post-exertional malaise, faintness, exhaustion, altered gut motility, and as many as 50-100 other symptoms. In the early 19th century, it was viewed as a physiological disorder of the nervous system, caused by unhealthy environmental factors such as poor diet, pollution, and the stresses of "modern life." In the latter part of the 19th century, the illness was recast as psychological, due, no doubt, to its prevalence among women. Although the term has fallen into disuse, it is still included in the International Statistical Classification of Diseases (ICD)-10 as a psychiatric diagnosis.

Neurasthenia as a diagnostic category was introduced in America in 1869 and quickly spread to Europe. Many have drawn parallels between the historical disease unit neurasthenia and contemporary conditions such as chronic fatigue syndrome / myalgic encephalopathy and burnout, but little is known about the early history of neurasthenia in Norway. Based on the Norwegian medical science journals from the period 1880 - 1920 we wanted to study the implementation, interpretation and application of the term neurasthenia in Norwegian medicine, with particular emphasis on symptoms, causes, treatment, prognosis and prevalence.

The results show that the term was probably first used in a Norwegian medical journal in 1876, and beyond 1880 is reported more and more people were diagnosed with neurasthenia. The condition was defined as a deterioration of the nervous system. Symptom picture was extensive, with fatigue as the main symptom. The reasons could not be verified or localized objectively and theories were many. Overstrain was a common explanation, but also trauma, infections, poor diet, heredity and sexual excesses were presumed causes. The recommended treatment was centered on strengthening the nervous system, through rest and electrification. The condition was described as typical of its time, in response to the "spirit" and modern life.